Understanding alcohol motivation using the alcohol purchase task: A methodological systematic review

Reinforcer value moderates response magnitude and persistence during extinction: A randomized trial

Extinction bursts, or temporary increases in rates and intensities of behavior during extinction, can preclude the inclusion of extinction in intervention packages meant to suppress severe challenging behavior. To identify underlying behavioral mechanisms responsible for response persistence and bursting, 69 adults with developmental disabilities completed a low-stakes translational investigation employing a 2 × 2 factorial, crossed, and randomized matched blocks design, with batched randomization logic. In each of the four test groups, we made distinct antecedent manipulations with two value parameters commonly studied through behavioral economics (i.e., demand intensity, Pmax) and evaluated the extent to which each of these manipulations influenced target responding during extinction. Although we found statistically significant differences attributable to both parameters, variations in reinforcer consumption relative to demand intensity were most influential across all dependent variables. This outcome implicates consumption relative to demand intensity as both a mitigating and exacerbating preextinction factor that influences the prevalence of adverse collateral extinction effects (e.g., bursts).

Neural correlates of increased alcohol demand following alcohol cue exposure in adult heavy drinkers

Alcohol use disorder is associated with overvaluation of alcohol relative to other rewards, in part due to dynamic increases in value in response to alcohol-related cues. In a neuroeconomic framework, alcohol cues increase behavioral economic demand for alcohol, but the neural correlates these cue effects are unknown. This functional magnetic resonance imaging study combined a neuroeconomic alcohol purchase task with an alcohol cue exposure in 72 heavy drinkers with established sensitivity to alcohol cues (51 % female; mean age=33.74). Participants reported how many drinks they would consume from $0-$80/drink following exposure to neutral and alcohol images in a fixed order. Participants purchased significantly more drinks in the alcohol compared to the neutral condition, which was also evident for demand indices (i.e., intensity, breakpoint, Omax, elasticity; ps<0.001; ds=0.46-0.92). Alcohol purchase decisions were associated with activation in rostral middle and medial frontal gyri, anterior insula, posterior parietal cortex, and dorsal striatum, among other regions. Activation was lower across regions in the alcohol relative to neutral cue condition, potentially due to greater automaticity of choices in the presence of alcohol cues or attenuation of responses due to fixed cue order. These results contribute to growing literature using neuroeconomics to understand alcohol misuse and provide a foundation for future research investigating decision-making effects of environmental alcohol triggers.

Longitudinal examination of alcohol demand and alcohol-related reinforcement as predictors of heavy drinking and adverse alcohol consequences in emerging adults

BACKGROUND AND AIMS

Behavioral economic theory predicts that high alcohol demand and high proportionate alcohol-related reinforcement are important determinants of risky alcohol use in emerging adults, but the majority of research to date has been cross-sectional in nature. The present study investigated prospective and dynamic relationships between alcohol demand and proportionate alcohol-related reinforcement in relation to heavy drinking days and alcohol problems.

DESIGN

Longitudinal cohort with assessments every 4 months for 20 months.

SETTING

Ontario, Canada.

PARTICIPANTS

Emerging adults reporting regular heavy episodic drinking (n = 636, Mage = 21.44; 55.8% female).

MEASUREMENTS

Heavy drinking days (HDD; Daily Drinking Questionnaire), alcohol problems (Brief Young Adult Alcohol Consequences Questionnaire), alcohol demand (Alcohol Purchase Task) and proportionate alcohol-related reinforcement (Activity Level Questionnaire).

FINDINGS

Linear mixed effects models revealed that behavioral economic indicators and alcohol-related outcomes significantly decreased over the study, consistent with 'aging out' of risky alcohol use. Random intercept cross-lagged panel models revealed significant between-person relationships, such that higher alcohol demand and alcohol-related reinforcement were positively associated with HDD and alcohol problems (random intercepts = 0.187-0.534, Ps < 0.01). Moreover, alcohol demand indicators (particularly the rate of change in elasticity of the demand curve, as measured by α, and the maximum expenditure, Omax) and proportionate alcohol-related reinforcement significantly forecasted changes in HDD at all time points (|βs| = 0.063-0.103, Ps < 0.05) in cross-lagged relationships, with bidirectional associations noted for the rate of change in elasticity (βs = -0.085 to -0.104, Ps < 0.01). Proportionate alcohol-related reinforcement also significantly forecasted changes in alcohol problems at all time points (βs = 0.072-0.112, Ps < 0.01).

CONCLUSIONS

Multiple behavioral economic indicators (demand elasticity, maximum expenditure and reinforcement ratio) forecast changes in heavy episodic drinking and alcohol problems over the course of emerging adulthood. These results further implicate alcohol demand and proportionate alcohol-related reinforcement as etiologically and developmentally important mechanisms in alcohol use trajectories.

Use of preexposure prophylaxis and condom purchasing decisions

Preexposure prophylaxis (PrEP) prevents human immunodeficiency virus (HIV) but not other sexually transmitted infections (STIs). Men who have sex with men (MSM) who take PrEP tend to report reduced condom use, but little is known about the underlying mechanisms. For this study, MSM who take PrEP (i.e., PrEP experienced; n = 88) and MSM who do not (i.e., PrEP naïve; n = 113) completed an online study, including the condom purchase task (CoPT). The CoPT assesses decisions to purchase condoms across escalating prices (range: free-$55) for sex with different types of hypothetical partners: those least likely to have an STD (least STD) and those that participants most want to have sex with (most want sex with). When condoms were free, PrEP-experienced MSM had a lower rate of condom purchasing than did PrEP-naïve MSM. For both partner types, PrEP-experienced MSM reached a price break point (i.e., would not buy condoms) at a lower price than did PrEP-naïve pariticipants. For the most-want-sex-with partner at the price at which participants elected not to buy condoms, only 23% of PrEP-experienced MSM chose to abstain from sex when not purchasing condoms versus 53% among PrEP-naïve MSM. Similar patterns were observed for the least-STD partner. The results support the potential utility of the CoPT in identifying behavioral mechanisms related to condom use and PrEP.

Behavioral economic analysis of legal and illegal cannabis demand in Spanish young adults with hazardous and non-hazardous cannabis use

BACKGROUND

In October 2021, a legal framework that regulates cannabis for recreational purposes in Spain was proposed, but research on its potential impacts on cannabis use is currently limited. This study examined the reliability and discriminant validity of two Marijuana Purchase Tasks (MPTs) for measuring hypothetical legal and illegal cannabis demand, and to examine differences in demand of both commodities in young adults at hazardous vs. non-hazardous cannabis use risk levels.

METHODS

A total of 171 Spanish young adults [Mage = 19.82 (SD = 1.81)] with past-month cannabis use participated in a cross-sectional study from September to November 2021. Two 27-item MPTs were used to estimate hypothetical demand for legal and illegal cannabis independently. The Cannabis Use Disorder Identification Test (CUDIT-R) was used to assess hazardous cannabis use and test for discriminant validity of the MPTs. Reliability analyses were conducted using Classical Test Theory (Cronbach's alpha) and Item Response Theory (Item Information Functions).

RESULTS

The MPT was reliable for measuring legal (α = 0.94) and illegal (α = 0.90) cannabis demand. Breakpoint (price at which demand ceases), and Pmax (price associated with maximum expenditure) were the most sensitive indicators to discriminate participants with different levels of the cannabis reinforcing trait. No significant differences between legal and illegal cannabis demand in the whole sample were observed, but hazardous vs. non-hazardous users showed higher legal and illegal demand, and decreased Breakpoint and Pmax if cannabis were legal vs illegal.

CONCLUSION

The MPT exhibits robust psychometric validity and may be useful to inform on cannabis regulatory science in Spain.

Using behavioral economics to optimize safer undergraduate late-night transportation

Many universities sponsor student-oriented transit services that could reduce alcohol-induced risks but only if services adequately anticipate and adapt to student needs. Human choice data offer an optimal foundation for planning and executing late-night transit services. In this simulated choice experiment, respondents opted to either (a) wait an escalating delay for a free university-sponsored "safe" option, (b) pay an escalating fee for an on-demand rideshare service, or (c) pick a free, immediately available "unsafe" option (e.g., ride with an alcohol-impaired driver). Behavioral-economic nonlinear models of averaged-choice data describe preference across arrangements. Best-fit metrics indicate adequate sensitivity to contextual factors (i.e., wait time, preceding late-night activity). At short delays, students preferred the free transit option. As delays extend beyond 30 min, most students preferred competing alternatives. These data depict a policy-relevant delay threshold to better safeguard undergraduate student safety.

Alcohol cues increase behavioral economic demand and craving for alcohol in nontreatment-seeking and treatment-seeking heavy drinkers

BACKGROUND

Behavioral economic research has revealed significant increases in alcohol demand following exposure to alcohol-related cues. Prior research has focused exclusively on nontreatment-seeking heavy drinkers, included only male participants, or used heterogeneous methods. The current studies sought to replicate and extend existing findings in treatment-seeking and nontreatment-seeking heavy drinkers while also examining sex effects and moderation by alcohol use disorder (AUD) severity.

METHODS

Study 1 included 117 nontreatment-seeking heavy drinkers (51.5% women; M age 34.69; 56.4% AUD+), and Study 2 included 89 treatment-seeking heavy drinkers with AUD (40.4% women; M age = 41.35). In both studies, alcohol demand was measured using a hypothetical alcohol purchase task (APT), and subjective alcohol craving was measured using visual analog scales. Measures were collected following exposure to neutral (water) cues in a standard room and alcohol cues in a bar lab.

RESULTS

Alcohol demand (intensity, Omax , breakpoint, and elasticity) and craving were significantly increased following alcohol cues compared to neutral cues (ps < 0.005) with effect sizes ranging from small to large (ηp 2  = 0.074-0.480). Participants with AUD (Study 1) or with higher AUD severity (Study 2) reported higher craving and higher demand for most indices (i.e., main effects; ps < 0.032, ηp 2  = 0.043-0.239). A larger alcohol cue increase in Omax was found for AUD+ participants in Study 1 compared to non-AUD participants (p = 0.028, ηp 2  = 0.041) but not for any other indices in Study 1 or Study 2. There were no significant sex effects.

CONCLUSIONS

These findings replicate and extend prior research by offering additional insight into alcohol cue effects on the reinforcing value of alcohol and subjective motivation to drink. The results also suggest that sex and AUD severity do not meaningfully impact cue effects across most indices of demand.

Reliability and validity of behavioral-economic measures: A review and synthesis of discounting and demand

This review sought to synthesize the literature on the reliability and validity of behavioral-economic measures of demand and discounting in human research, introduce behavioral-economic research methodologies for studying addictive behaviors, discuss gaps in the current literature, and review areas for future research. A total of 34 studies was included in this review. The discounting literature showed similar responding regardless of whether hypothetical or actual outcomes were used, though people tended to discount the outcome presented first more steeply, suggesting order effects. Although delay-discounting measures seem to show temporal stability, exceptions were found for probability- and experiential-discounting tasks. The demand literature also demonstrated similar responding regardless of outcome type; however, some demand indices showed exceptions. Randomized price sequences tended to show modest increases in Omax and α and modestly higher rates of inconsistent or nonsystematic responses compared with sequential price sequences. Demand indices generally showed temporal stability, although the stability was weaker the larger the time interval between test sessions. Future studies would benefit by examining addictive commodities beyond alcohol, nicotine, and money; examining temporal stability over longer time intervals; using larger delays in discounting tasks; and using larger sample sizes.

A Scoping Review on the Role of Sexual Orientation and Gender Identity Microaggressions in Substance Use

Objectives

Disparities in substance use patterns and outcomes are evident among sexual and gender minority groups. Sexual orientation and gender identity (SOGI) microaggression, or the subtle forms of aggression experienced by lesbian, gay, bisexual, transgender, gender non-conforming/non-binary, and gender diverse individuals, has recently been explored as a mechanism that leads to negative adjustment outcomes, including substance use. In this study we examined extant literature on the association between SOGI microaggression and substance use, and the intermediary factors that mediate or moderate this relationship.

Method

Scoping review method was used to systematically map the literature base using database aggregators (e.g., Scopus, EBSCO) following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines.

Results

We found that SOGI microaggression is positively associated with substance use and negative consequences, and this relationship is mediated or moderated by motivational, relational, and identity processes.

Conclusion

These findings suggest the need to consider microaggression experience when working with clients of diverse sexual and gender identities. Likewise, additional studies are needed on other intermediary factors and effects of microaggression on substances other than alcohol. Most importantly, this study underscores the need for understanding the link between microaggression and substance use in greater efforts to promote sexual well-being and building competence in fostering the trifecta of sexual health, sexual rights, and sexual pleasure.

The Blinded-Dose Purchase Task: assessing hypothetical demand based on cocaine, methamphetamine, and alcohol administration

RATIONALE

Behavioral economic drug purchase tasks quantify the reinforcing value of a drug (i.e., demand). Although widely used to assess demand, drug expectancies are rarely accounted for and may introduce variability across participants given diverse drug experiences.

OBJECTIVES

Three experiments validated and extended previous hypothetical purchase tasks by using blinded drug dose as a reinforcing stimulus, and determined hypothetical demand for experienced effects while controlling for drug expectancies.

METHODS

Across three double-blind, placebo-controlled, within-subject experiments, cocaine (0, 125, 250 mg/70 kg; n=12), methamphetamine (0, 20, 40 mg; n=19), and alcohol (0, 1 g/kg alcohol; n=25) were administered and demand was assessed using the Blinded-Dose Purchase Task. Participants answered questions regarding simulated purchasing of the blinded drug dose across increasing prices. Demand metrics, subjective effects, and self-reported real-world monetary spending on drugs were evaluated.

RESULTS

Data were well modeled by the demand curve function, with significantly higher intensity (purchasing at low prices) for active drug doses compared to placebo for all experiments. Unit-price analyses revealed more persistent consumption across prices (lower α) in the higher compared to lower active dose condition for methamphetamine (a similar non-significant finding emerged for cocaine). Significant associations between demand metrics, peak subjective effects, and real-world spending on drugs also emerged across all experiments.

CONCLUSIONS

Orderly demand curve data revealed differences across drug and placebo conditions, and relations to real-world measures of drug spending, and subjective effects. Unit-price analyses enabled parsimonious comparisons across doses. Results lend credence to the validity of the Blinded-Dose Purchase Task, which allows for control of drug expectancies.

A contextualized reinforcer pathology approach to addiction

Behavioural economic accounts of addiction conceptualize harmful drug use as an operant reinforcer pathology, emphasizing that a drug is consumed because of overvaluation of smaller immediate rewards relative to larger delayed rewards (delay discounting) and high drug reinforcing value (drug demand). These motivational processes are within-individual determinants of behaviour. A third element of learning theory posits that harmful drug use depends on the relative constraints on access to other available activities and commodities in the choice context (alternative reinforcers), reflecting the substantial influence of environmental factors. In this Perspective, we integrate alternative reinforcers into the contemporary behavioural economic account of harmful drug use - the contextualized reinforcer pathology model - and review empirical literature across the translational spectrum in support of this model. Furthermore, we consider how increases in drug-related mortality and health disparities in addiction can be understood and potentially ameliorated via a contextualized reinforcer pathology model in which lack of alternative reinforcement is a major risk factor for addiction.

Can initial experiences with drugs predict future drug abuse risks?

Initial experiences with drugs may influence an individual's motivations for continued use. This study evaluated the relationship between subjective effects elicited by an individual's first use of alcohol or cannabis, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alcohol use disorder (AUD) or cannabis use disorder (CUD) severity, and behavioral economic demand for alcohol or cannabis. Self-reports of initial subjective effects associated with drugs were analyzed for N = 463 participants whose first substance use was either alcohol or cannabis. The likelihood that a particular subjective effect at the time of first use was associated with current AUD/CUD was assessed using ordinal logistic regression with subjective effects as predictors of DSM-5 severity. Behavioral economic demand was assessed using a hypothetical purchase task in which participants indicated their hypothetical consumption of alcohol or cannabis as a function of price. Significant associations were observed for initial subjective effects elicited by alcohol or cannabis and increased DSM-5 severity: (alcohol) relief (OR = 2.52 [95% CI 1.51-4.25], p = .0005) and (cannabis) energetic (OR = 2.31 [95% CI 3.27-55.5], p = .0004). The mean (± SEM) Pmax value for the alcohol subgroup endorsing relief ($96.22 ± $26.48) was significantly greater than the Pmax value for the alcohol subgroup not endorsing relief ($33.81 ± $12.93), t(237) = 2.276, p = .0237. These results suggest that the initial subjective effects associated with a given substance may predict the development and/or severity of substance misuse and substance use disorders (SUDs). These findings are consistent with anecdotal reports that persons with SUD feel energized by the use of substances whereas persons without SUD do not report experiencing such subjective effects upon first use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Extra-experimental scarcity impacts hypothetical operant demand: A natural SARS-CoV-2 eperiment

Behavioral economic demand models quantify the extent to which an organism defends its consumption of a commodity. Commodity purchase tasks permit humans a quick yet psychometrically sound approach to assessing commodity demand for various retail products. Operant behavioral economic literature suggests economy type (open vs closed) can significantly alter demand, yet this effect is largely undocumented in the commodity purchase task literature. In this study, we leveraged the market pressures for retail goods (hand lotion and sanitizer; paper towels and toilet paper; soda and water) resulting from SARS-CoV-2 into a natural experiment comparing within-subject demand across two time-points during the pandemic using a crowdsourced approach. Results suggest that hypothetical commodity purchase tasks are sensitive to extra-experimental market pressures (e.g., scarcity due to the closing of economies), adding additional confidence to the self-report nature of purchase task responding and providing further construct validity to these approaches.

Behavioral economic relationship between cannabis and cigarettes: Evidence from hypothetical purchase tasks

BACKGROUND

In the United States (U.S), cannabis policies have been increasingly liberalized whereas tobacco policies have been increasingly stringent. Given the high prevalence of cannabis and tobacco dual use, there are concerns that a policy regulating one substance may unintendedly influence the other. This study examined the responsiveness of the demand for cannabis joints and cigarettes when price varied.

METHODS

The study included 338 adult participants (21+) who used both cannabis and tobacco and lived in one of the U.S. states with recreational cannabis legalized by the time of interview in 2019. They completed hypothetical purchase tasks to indicate the quantity desired of cannabis joints and cigarette packs 1) when only one substance was available with escalating prices and 2) when both substances were concurrently available with escalating prices of cannabis joints and a fixed price of cigarette packs. We estimated 1) the own-price elasticity of demand for each substance using nonlinear exponential demand model, and 2) the cross-price elasticity of demand at aggregate level using nonlinear exponential demand model and at individual level using log-linear demand model.

RESULTS

The estimates for the rate of change of own-price elasticity (α) were 0.0011 (SE = 0.000039, p < 0.001) for cannabis joints and 0.00095 (SE = 0.000037, p < 0.001) for cigarette packs. The aggregate-level estimates of cross-price elasticity (I = 13.032, SE = 0.34, p < 0.001; β = 0.0029, SE = 0.0021, p > 0.05) suggest an independent relationship between the two substances. At individual level, 78.70% of the participants treated the two substances as independent, 17.46% as complements, and 3.85% as substitutes.

CONCLUSIONS

For most adults who used both cannabis and tobacco in the U.S., cannabis joints and cigarettes had an independent relationship. Policies regulating the price of cannabis may not have large unintended consequences on cigarette use.

Hyperbolic discounting and exponentiated demand: Modeling demand for cigarettes in three dimensions

Behavioral economics has been a fruitful area of research in substance use. Mathematical descriptions of how individuals temporally discount the value of a commodity have been correlated with substance use and mathematical descriptions of drug consumption decreasing as a function of price (i.e., demand) predict maladaptive substance use. While there is a logical assumption that temporal factors affect demand for a drug, little has been done to merge these models. Thus, the purpose of this study was to combine models of discounting and demand, extending Howard Rachlin's work and contributions to novel areas of study. Data from 85 participants from Amazon Mechanical Turk (MTurk) who completed a hypothetical cigarette purchase task that included price of and delay to cigarettes were analyzed. Multilevel modeling was used to determine descriptive accuracy of combined additive and multiplicative models of discounting and demand. Of the discounting models used in conjunction with the exponentiated demand equation, the Rachlin hyperboloid best described the delay dimension of consumption. The multiplicative version of the Rachlin equation applied to both delay and price outperformed other models tested. Therefore, existing models of discounting and demand can be extended to modeling consumption data from complex multidimensional experimental arrangements.

Demand and cross-price elasticity of cocaine and social contact in a free-operant procedure of nonexclusive choice

Research examining the social determinants of addiction has advanced significantly with the recent development of preclinical models of drug use and the social environment. These models reveal that drug use and social contact compete with one another for behavioral expression in discrete-trial choice procedures using concurrent schedules of reinforcement. The purpose of this study was to determine how concurrent access to cocaine and a social partner influences the demand for each alternative under free-operant conditions in which responding maintained by each reinforcer is independent and nonexclusive of the other. To this end, male rats were trained under a free-operant, concurrent schedule of reinforcement in which responding maintained by cocaine and access to a social partner operated independently of one another. Measures of economic demand (e.g., intensity, Omax, cross-price elasticity) were determined by manipulating the response requirement (i.e., fixed ratio value) across sessions. Tests were conducted in which the social partner was either treated or not treated with cocaine to determine whether the intoxication state of the partner influenced demand. The principal findings of this study are (1) demand for a cocaine-treated partner is greater than demand for a cocaine-free partner, (2) demand for cocaine is greater in the presence of a cocaine-treated partner than a cocaine-free partner, and (3) concurrent access to cocaine decreases demand for social contact. Notably, measures of cross-price elasticity indicated that social contact is a robust economic substitute for cocaine.

Behavioral economics indices predict alcohol use and consequences in young men at 4-year follow-up

BACKGROUND AND AIMS

The alcohol purchase task (APT), which presents a scenario and asks participants how many drinks they would purchase and consume at different prices, generates indices of alcohol reward value that have shown robust associations with alcohol-related outcomes in numerous studies. The aim was to test its prospective validity at 4-year follow-up.

DESIGN

Prospective cohort study.

SETTING

General population sample of young Swiss men.

PARTICIPANTS

A total of 4594 Swiss young men (median age = 21, 25th - 75th quartiles = 20.5 - 21.5) completed baseline questionnaires; among those, 4214 (91.7%) were successfully followed-up 4 years later.

MEASUREMENTS

Alcohol reward value parameters (i.e. intensity, the planned consumption when drinks are free; breakpoint, the price at which consumption would be suppressed; O_max , the maximum alcohol expenditure; P_max , the price associated with O_max ; and elasticity, the relative change in alcohol consumption as a function of the relative change in price) were derived from the APT at baseline and used to predict self-reported weekly drinking amount, monthly binge drinking, alcohol-related consequences and DSM-5 alcohol use disorder criteria.

FINDINGS

Regression analyses, adjusting for the baseline alcohol measure, age, linguistic region and socio-economic indicators showed that intensity, breakpoint, O_max and elasticity significantly predicted all tested outcomes in the expected direction (e.g. standardized incidence rate ratio [95% confidence interval] = 1.11 [1.07-1.15], 1.07 [1.03-1.10], 1.08 [1.04-1.11], and 0.92 [0.89-0.95], respectively, for weekly drinking amount, all P < 0.001). P_max did not significantly predict any outcomes. Non-adjusted correlations, baseline adjusted regression and ancillary analyses using (1) latent alcohol variables, (2) multiple imputation for missing data and (3) replications in training and testing subsamples to evaluate predictive accuracy provided consistent findings.

CONCLUSIONS

The alcohol purchase task demand curve measures of alcohol reward value are useful in characterizing alcohol-related risk in young men and have long-term predictive utility.

Measuring Sexual Risk-Taking: A Systematic Review of the Sexual Delay Discounting Task

The Sexual Delay Discounting Task (SDDT; Johnson & Bruner, 2012) is a behavioral economic task that assesses sexual risk-taking by measuring likelihood of immediate and delayed condom use. The SDDT is ecologically valid and has been used to test effects of various substances on sexual risk-taking. However, considerable variety in implementation, analysis, and reporting of the SDDT may limit rigor and reproducibility of findings. The current review synthesized studies that used the SDDT to evaluate these possible variabilities systematically. A two-step search (citation-tracking and keyword-based search) was conducted to identify studies that met inclusion criteria (i.e., used the SDDT). Eighteen peer-reviewed articles met inclusion criteria. The SDDT has been implemented primarily in three populations: individuals who use cocaine, men who have sex with men, and college students. Comparable results across diverse populations support the SDDT's validity. A few studies administered substances before the SDDT. Evidence suggests that while cocaine and alcohol increased sexual risk-taking under some conditions, buspirone decreased preference for immediate condomless sex. There was also heterogeneity in the determination of data orderliness (i.e., outliers) and inconsistent reporting of task design and analysis. Considerable differences present in methodologic approaches could influence results. Reducing variation in the administration, analysis, and reporting of the SDDT will enhance rigor and reproducibility and maximize the task's tremendous potential.

Understanding data quality: Instructional comprehension as a practical metric in crowdsourced investigations of behavioral economic cigarette demand

Crowdsourcing platforms allow researchers to quickly recruit and collect behavioral economic measures in substance-using populations, such as cigarette smokers. Despite the broad utility and flexibility, data quality issues have been an object of concern. In two separate studies recruiting cigarette smokers, we sought to investigate the association between a practical quality control measure (accuracy on an instruction quiz), on internal consistency of number of cigarettes smoked per day and purchasing patterns of tobacco products in an experimental tobacco marketplace (ETM; Study 1), and in a cigarette purchase task (CPT; Study 2). Participants (N = 312 in Study 1; N = 119 in Study 2) were recruited from Amazon mechanical turk. Both studies included task instructions, a quiz, a purchase task, cigarette usage and dependence questions, and demographics. The results show that participants who answered all instruction items correctly: (a) reported the number of cigarettes per day more consistently (partial η² = 0.11, p < .001, Study 1; partial η² = 0.09, p = .016, Study 2), (b) demonstrated increased model fit among the cigarette demand curves (partial η² = 0.23, p < .001, Study 1; partial η² = 0.08, p = .002, Study 2), and purchased tobacco products in the ETM more consistently with their current usage. We conclude that instruction quizzes before purchase tasks may be useful for researchers evaluating demand data. Instruction quizzes with multiple items may allow researchers to choose the level of data quality appropriate for their studies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Using crowdsourcing to study the differential effects of cross-drug withdrawal for cigarettes and opioids in a behavioral economic demand framework

Smoking rates among those who use prescribed or recreational opioids are significantly higher than the general population. Hypothesized neuropharmacological interactions between opioids and nicotine may contribute to this pattern of polysubstance use, especially during withdrawal. However, little research has examined how the withdrawal of one substance may affect the consumption of the other (i.e., cross-drug withdrawal effects). Behavioral economic demand tasks (e.g., hypothetical purchase tasks) can be used to quickly assess the value of a drug. Crowdsourcing can be a convenient tool to gain preliminary insight into different processes in substance valuation that may otherwise be impossible or prohibitively difficult to study. The purpose of the present study was to provide a preliminary examination of the effects of hypothetical withdrawal of cigarettes and opioids on the consumption of those drugs among polysubstance users. Amazon Mechanical Turk workers who reported daily smoking and at least monthly opioid use completed a series of hypothetical purchase tasks for doses of opioids and cigarettes under various withdrawal conditions. Sensitivity to the price of both drugs decreased when under withdrawal for either, indicating a higher drug value of cigarettes and opioids due to effects of cross-drug withdrawal. Nicotine and opioid dependence severity, impulsive choice, and riskiness were also positively related to drug purchasing. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

(Non-) impact of task experience on behavioral economic decision-making

Behavioral economic research has been widely conducted via crowdsourcing resources to evaluate novel task designs or pilot interventions. One under recognized and yet-to-be tested concern is the impact of non-naïvety (i.e., prior task exposure) on behavioral economic task performance. We evaluated the influence of non-naïvety on task performance in two popular areas of behavioral economic research: behavioral economic demand and delay discounting. Participants (N = 485) recruited using Amazon Mechanical Turk (mTurk) completed alcohol and soda purchase tasks and delay discounting tasks for monetary and alcohol outcomes. Equivalence of responding and effect sizes with clinical variables were compared based on prior task experience. Over one quarter of participants reported demand task experience (26.9%) and nearly half endorsed delay discounting task experience (48.6%). Statistically equivalent responding was observed for alcohol purchase task data with less-than-small effect size differences based on task experience (d = 0.01-0.13). Similar results were observed for a soda purchase task thereby supporting generalization to a non-alcohol commodity. Measures of convergent and discriminant validity for behavioral economic demand indicated medium-to-large and stimulus-specific effect sizes with little variation based on prior task exposure. Delay discounting for money and alcohol showed some sensitivity to prior task experience (i.e., less steep discounting for non-naïve participants), however these effects were attenuated after accounting for group differences in alcohol use. These findings support the fidelity of behavioral economic task outcomes and emphasize that participant non-naïvety in crowdsourcing settings may minimally impact performance on behavioral economic assays commonly used in behavioral and addiction science. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Behavioral economic demand modeling chronology, complexities, and considerations: Much ado about zeros

Behavioral economic demand has been shown to have high utility in quantifying the value or consumption of a commodity. Demand describes the relationship between cost and consumption of a commodity, and tends to be curvilinear with consumption approaching zero as the cost increases to a sufficiently high cost to suppress consumption completely. Over a period spanning greater than three decades, behavioral economists have made great strides in the modeling of demand and addressing analytical challenges, although this work is not complete and unresolved challenges remain. The analytical challenges associated with modeling zeros both when they arise as consumption values of zero and when consumption at zero cost is assessed have been a substantial part of this evolution in models. The goals of this methodological review are to provide a historical overview of the major behavioral economic demand models that have been proposed, describe some of the common difficulties with analyzing behavioral economic demand, and discuss general considerations for the analysis of demand. In an environment with evolving and multiple competing analytical practices, we conclude that researchers can maximize scientific rigor by embracing transparency in their analysis choices and employing techniques such as sensitivity analyses to determine if their analysis choices impact the conclusions of their experiments.

Applications of operant demand to treatment selection III: Consumer behavior analysis of treatment choice

Behavior analysts and psychologists advocate for the use of therapies and strategies based on credible, scientific evidence. Researchers and clinicians regularly advocate for Evidence-based Practices (EBPs) over questionable "alternatives" because caregivers seldom choose interventions based on scientific evidence alone. This study applied methods and concepts from Consumer Behavior Analysis to conduct a reinforcer-based evaluation of the consequences that influence treatment choices. Hypothetical Treatment Purchase Tasks (HTPTs) were designed to evaluate how utilitarian (UR; i.e., the efficacy of treatment) and informational sources of reinforcement (IR; i.e., community support for treatment) jointly influence treatment-related choices. A total of 104 caregivers were recruited using the Amazon Mechanical Turk (MTurk) framework to complete two HTPTs. Results indicated that caregivers overall favored treatments with greater IR over those with greater UR, suggesting that indirect contingencies for treatment choices exerted greater overall influence than the direct contingencies of treatment choices (i.e., efficacy). This finding extends the literature on treatment choice by providing a reinforcer-based perspective on why 'fad', questionable, and pseudoscientific practices can achieve and maintain high levels of adoption by caregivers. This work concludes with a discussion of Consumer Behavior Analysis and how reinforcer-based interpretations of choice can be used to improve efforts to support and advocate for evidence-based child behavior treatments.

A Brief Introduction to Human Behavioral Pharmacology: Methods, Design Considerations and Ethics

Human behavioral pharmacology methods have been used to rigorously evaluate the effects of a range of centrally acting drugs in humans under controlled conditions for decades. Methods like drug self-administration and drug discrimination have been adapted from nonhuman laboratory animal models. Because humans have the capacity to communicate verbally, self-report methods are also commonly used to understand drug effects. This perspective article provides an overview of these traditional human behavioral pharmacology methods and introduces some novel methodologies that have more recently been adapted for use in the field. Design (e.g., using placebo controls, testing multiple doses) and ethical (e.g., avoiding enrollment of individuals seeking treatment, determining capacity to consent) considerations that must be addressed when conducting these types of studies are also described.

Associations between alcohol demand and both the experience and subjective evaluation of positive and negative alcohol-related consequences

BACKGROUND

Considerable variation exists in the extent to which alcohol-related consequences are evaluated as positive or negative. These evaluations, in turn, predict subsequent drinking behavior. Understanding the etiological pathways to positive and negative alcohol-related consequences is essential to the design of interventions aimed at reducing drinking consequences. Behavioral economic models posit that excessive alcohol valuation contributes to problematic use. Elevated alcohol demand (i.e., relative alcohol value) is associated with negative alcohol-related consequences; however, it is unclear whether demand is related to positive consequences or subjective consequence evaluations.

METHODS

College student drinkers (n = 114; 74.6% female) completed an online survey. Participants indicated whether they had ever experienced any of 24 negative and 14 positive consequences and subjectively evaluated their most recent experience of each consequence endorsed. An alcohol purchase task assessed hypothetical alcohol consumption across 14 prices and three observed demand indices were calculated: intensity (i.e., consumption at zero cost), O_max (i.e., maximum expenditure), and P_max (i.e., price associated with maximum expenditure). Bivariate correlations and hierarchical regressions were used to test associations between observed demand indices and the number and subjective evaluations of positive and negative (researcher- and participant-defined) consequences.

RESULTS

Intensity and O_max , but not P_max , were bivariately associated with researcher- and participant-defined negative and positive consequences. However, in hierarchical regression models that controlled for the maximum number of drinks consumed in a single day over the past month, only intensity was significantly associated with more negative and positive consequences. Intensity was associated with positive consequence evaluations in bivariate but not regression models.

CONCLUSION

Students with higher intensity reported more prior alcohol consequences (positive and negative), independent of drinking level. However, subjective evaluations of recent consequences did not vary as a function of demand. Results support using behavioral economic models to facilitate identifying etiologic pathways to alcohol consequences and suggest that novel interventions incorporating demand manipulation may reduce drinking consequences.

The behavioral economics of alcohol demand in Greek-affiliated college students

BACKGROUND

College students affiliated with fraternity and sorority, or "Greek" life represent a known high-risk group for alcohol consumption and related consequences, but little is known about demand for alcohol in this population. The current study examined behavioral economic demand for alcohol in a sample of Greek life-affiliated undergraduate students using the alcohol purchase task (APT) and a novel variation of the APT that included a fixed-price, nonalcoholic alternative (APT Choice).

METHODS

Participants (n = 229) completed the APT, APT Choice, Alcohol Use Disorders Identification Test (AUDIT), and Daily Drinking Questionnaire (DDQ). Group demand indices were calculated for the entire sample and then separately for participants who met or did not meet the legal drinking age (21+ or underage, respectively). Independent-sample t tests assessed whether there were any significant differences between the two age cohorts in the percent change in each behavioral economic index from the APT to APT Choice. Tests of correlation evaluated the construct validity of the demand indices from both hypothetical purchase tasks.

RESULTS

Descriptive statistics on alcohol use in this Greek-affiliated sample revealed "hazardous" drinking scores, with AUDIT-C scores exceeding the threshold of alcohol misuse. These measures were significantly correlated with demand indices from both APT conditions, and demand was inversely related to price; however, demand for alcohol was reduced when a nonalcoholic alternative was available. Both age cohorts reported a reduction in BP₁ (highest price of nonzero consumption) and an increase in α (rate of change in elasticity), but these changes were significantly greater among underage participants.

CONCLUSIONS

Although Greek life-affiliated students demonstrate high demand for alcohol, the concurrent availability of a nonalcoholic alternative reduces alcohol demand, particularly for underage students. These findings suggest that nonalcoholic options may enhance the effectiveness of increasing alcohol prices to reduce alcohol consumption among students at higher risk for alcohol use.

Hidden equivalence in the operant demand framework: A review and evaluation of multiple methods for evaluating nonconsumption

Operant translations of behavioral economic concepts and principles have enhanced the ability of researchers to characterize the effects of reinforcers on behavior. Operant behavioral economic models of choice (i.e., Operant Demand) have been particularly useful in evaluating how the consumption of reinforcers is affected by various ecological factors (e.g., price, limited resources). Prevailing perspectives in the Operant Demand Framework are derived from the framework presented in Hursh and Silberberg (2008). Few dispute the utility of this framework and model, though debate continues regarding how to address the challenges associated with logarithmic scaling. At present, there are competing views regarding the handling of nonconsumption (i.e., 0 consumption values) and under which situations that alternative restatements of this framework are recommended. The purpose of this report was to review the shared mathematical bases for the Hursh and Silberberg and Koffarnus et al. (2015) models and how each can accommodate nonconsumption values. Simulations derived from those featured in Koffarnus et al. were used to conduct tests of equivalence between modeling strategies while controlling for interpretations of residual error as well as the absolute lower limit. Simulations and proofs were provided to illustrate how neither the Hursh and Silberberg nor Koffarnus et al. models can characterize demand at 0 and how both ultimately arrive at the same upper and lower limits. These findings are discussed, and recommendations are provided to build consensus related to zero consumption values in the Operant Demand Framework.

At-Risk Drinking, Operant Demand, and Cross-Commodity Discounting as Predictors of Drunk Driving in Underage College Women

Behavioral economics offers unique tools for assessing value and motivation associated with college drinking. Tasks that model changes in consumption as a function of price (operant demand) or the decline in an outcome's subjective value as a function of time-to-occurrence (delay discounting) provide valuable information that may efficiently supplement clinical screening instruments when characterizing alcohol use severity. The first aim of this investigation was to examine the extent to which at-risk drinking, operant demand for alcohol, and single- and cross-commodity discounting of money and alcohol predict adverse consequences of past-month drinking in underage college women (N = 72). The second aim was to determine whether these clinical and behavioral economic measures could significantly predict the odds of past-month drunk driving, a serious public health concern due to the increasing prevalence of heavy episodic drinking among women in their first 1 - 2 years of college. Results showed that higher scores on the consumption factor of the Alcohol Use Disorder Identification Test (AUDIT-C), greater Persistence (consumption amidst constraint) and Amplitude (maximum consumption) of demand, as well as lower rates of discounting for choices between receiving alcohol now or double the amount after a delay (choosing the larger amount of alcohol even when it is delayed) significantly predicted adverse consequences of past-month drinking. Moreover, scores on the AUDIT-C, Amplitude of demand, and higher rates of discounting for choices between receiving alcohol now and money later (choosing immediately available alcohol at the expense of double the equivalent in delayed money) significantly predicted past-month drunk driving. We contend that operant demand along with single- and cross-commodity discounting can be viewed as intersecting measures of reinforcer value with clinical relevance to college women.

Exploring regulation and function of dopamine D3 receptors in alcohol use disorder. A PET [11C]-(+)-PHNO study

Preclinical studies support an important role of dopamine D3 receptors (DRD3s) in alcohol use disorder (AUD). In animals, voluntary alcohol consumption increases DRD3 expression, and pharmacological blockade of DRD3s attenuates alcohol self-administration and reinstatement of alcohol seeking. However, these findings have yet to be translated in humans. This study used positron emission tomography (PET) and [¹¹C]-(+)-PHNO to compare receptor levels in several dopamine D2 receptor (DRD2) and DRD3 regions of interest between AUD subjects in early abstinence (n = 17; 6.59 ± 4.14 days of abstinence) and healthy controls (n = 18). We recruited non-treatment seeking subjects meeting DSM-5 criteria for AUD. We examined the relationship between DRD2/3 levels and both alcohol craving and alcohol motivation/wanting, using a cue reactivity procedure and an intravenous alcohol self-administration (IVASA) paradigm, respectively. [¹¹C]-(+)-PHNO binding levels in AUD subjects were significantly lower than binding in HCs when looking at all DRD2/3 ROIs jointly (Wilk's Λ = .58, F(6,28) =3.33, p = 0.013, η²_p = 0.42), however there were no region-specific differences. Binding values demonstrate -12.3% and -16.1% lower [¹¹C]-(+)-PHNO binding in the SMST and SN respectively, though these differences did not withstand Bonferroni corrections. There was a positive association between [¹¹C]-(+)-PHNO binding in the SN (almost exclusively reflective of DRD3) and alpha (lower values reflect higher alcohol demand) in the APT after Bonferroni corrections (r = 0.66, p = 0.0080). This demonstrates that AUD subjects with lower DRD3 levels in the SN exhibit increased demand for alcohol. These results replicate previous findings demonstrating reduced DRD2/3 levels while also supporting a lack of DRD3 upregulation and potential downregulation in early abstinent AUD. Furthermore, the finding that binding in the SN is associated with alcohol demand warrants further examination.

Applying Mixed-Effects Modeling to Behavioral Economic Demand: An Introduction

Behavioral economic demand methodology is increasingly being used in various fields such as substance use and consumer behavior analysis. Traditional analytical techniques to fitting demand data have proven useful yet some of these approaches require preprocessing of data, ignore dependence in the data, and present statistical limitations. We term these approaches "fit to group" and "two stage" with the former interested in group or population level estimates and the latter interested in individual subject estimates. As an extension to these regression techniques, mixed-effect (or multilevel) modeling can serve as an improvement over these traditional methods. Notable benefits include providing simultaneous group (i.e., population) level estimates (with more accurate standard errors) and individual level predictions while accommodating the inclusion of "nonsystematic" response sets and covariates. These models can also accommodate complex experimental designs including repeated measures. The goal of this article is to introduce and provide a high-level overview of mixed-effects modeling techniques applied to behavioral economic demand data. We compare and contrast results from traditional techniques to that of the mixed-effects models across two datasets differing in species and experimental design. We discuss the relative benefits and drawbacks of these approaches and provide access to statistical code and data to support the analytical replicability of the comparisons.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40614-021-00299-7.

Review of Changes in the Reinforcing Effects of Alcohol in Weight Loss Surgery Patients

PURPOSE OF REVIEW

The reinforcing effects of alcohol are well documented, and they have been shown to play a role in the development of alcohol use disorders (AUDs). Also well established is the fact that post-weight loss surgery (WLS) patients are at an increased risk for AUDs. In the current manuscript, we review the notion that the reinforcing effects of alcohol may change from before to after WLS and discuss a number of determinants of alcohol reinforcement change in WLS patients.

RECENT FINDINGS

It has been increasingly well understood that WLS patients are at an increased risk for AUD, but empirical support for the mechanisms that may cause this phenomenon have been lacking. Recently, a model was proposed that offered a number of different potentially causal variables as mechanisms that result in increased risk for AUD in these surgical patients. Change in the extent to which alcohol is reinforcing to WLS patients may be key in determining the likelihood of AUDs in this group. We review a host of biological, psychological, and social variables that ultimately impact how reinforcing alcohol is to WLS patients.

Concurrent validity of the Alcohol Purchase Task for measuring the reinforcing efficacy of alcohol: an updated systematic review and meta-analysis

BACKGROUND AND AIMS

An early meta-analysis testing the concurrent validity of the Alcohol Purchase Task (APT), a measure of alcohol's relative reinforcing value, reported mixed associations, but predated a large number of studies. This systematic review and meta-analysis sought to: (1) estimate the relationships between trait-based alcohol demand indices from the APT and multiple alcohol indicators, (2) test several moderators and (3) analyze small study effects.

METHODS

A meta-analysis of 50 cross-sectional studies in four databases (n = 18 466, females = 43.32%). Sex, year of publication, number of APT prices and index transformations (logarithmic, square root or none) were considered as moderators. Small study effects were examined by using the Begg-Mazumdar, Egger's and Duval & Tweedie's trim-and-fill tests. Alcohol indicators were quantity of alcohol use, number of heavy drinking episodes, alcohol-related problems and hazardous drinking. APT indices were intensity (i.e. consumption at zero cost), elasticity (i.e. sensitivity to increases in costs), O_max (i.e. maximum expenditure), P_max (i.e. price associated to O_max ) and breakpoint (i.e. price at which consumption ceases).

RESULTS

All alcohol demand indices were significantly associated with all alcohol-related outcomes (r = 0.132-0.494), except P_max , which was significantly associated with alcohol-related problems only (r = 0.064)_. The greatest associations were evinced between intensity in relation to alcohol use, hazardous drinking and heavy drinking and between O_max and alcohol use. All the tested moderators emerged as significant moderators. Evidence of small-study effects was limited.

CONCLUSIONS

The Alcohol Purchase Task appears to have concurrent validity in alcohol research. Intensity and O_max are the most relevant indices to account for alcohol involvement.

An evaluation of fixed and randomized price sequence on the alcohol purchase task

Factors influencing drug consumption can be effectively evaluated in the context of behavioral economic demand. Specifically, hypothetical purchase tasks (HPTs) allow for estimated drug consumption at a range of prices in which drug administration is not ethically or feasibly possible. With the marked increase of HPTs in behavioral research, understanding methodological influences on responding is paramount. One such methodological consideration is the price sequence, which can be presented in a fixed, ascending order or a randomized sequence. This study compared fixed and fully randomized sequence order with college student drinkers using a within-subjects design. Self-reported consumption revealed that despite some small differences between the fixed and random sequences, consumption preferences were highly similar, regardless of presentation order. These results suggest participants are likely not anchoring their responses to the prior price on a fixed-order sequence. We conclude with a discussion on how these findings provide implications for HPTs and future research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Behavioral economic indicators of risky drinking among community-dwelling emerging adults

Objective: Behavioral economic (BE) approaches to understanding and reducing risky drinking among college students are well established, but little is known about the generalizability of prior findings to peers who currently are not traditional college students and are more difficult to reach for assessment and intervention. This cross-sectional survey investigated whether drinking practices and negative consequences were associated with greater alcohol demand, alcohol reward value, and delay discounting in this target population. Method: Community-dwelling emerging adult drinkers aged 21 to 29 (N = 357) were recruited using Respondent-Driven Sampling adapted to a digital platform (Mage = 23.6 years, 64% women). Peers recruited peers in an iterative fashion. Participants completed a web-based survey of drinking practices, negative alcohol-related consequences, and BE measures of alcohol demand, alcohol reward value, and delay discounting. Results: Regression analyses supported the study hypotheses. Higher alcohol demand (intensity and elasticity) predicted higher drinks per drinking day, more past-month drinking days, and more negative consequences. Higher alcohol reward value (discretionary alcohol spending and alcohol-involved activities) and stronger preference for sooner smaller versus later larger rewards predicted select drinking risk variables in the hypothesized direction (p < .05). Conclusions: BE risk characteristics were generalized to community-dwelling emerging adult risky drinkers, with the most consistent associations found between alcohol demand and drinking risk measures. The findings lay a foundation for extending successful BE interventions with college drinkers to this underserved population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A zero-bounded model of operant demand

Contemporary approaches for evaluating the demand for reinforcers use either the Exponential or the Exponentiated model of operant demand, both derived from the framework of Hursh and Silberberg (2008). This report summarizes the strengths and complications of this framework and proposes a novel implementation. This novel implementation incorporates earlier strengths and resolves existing shortcomings that are due to the use of a logarithmic scale for consumption. The Inverse Hyperbolic Sine (IHS) transformation is reviewed and evaluated as a replacement for the logarithmic scale in models of operant demand. Modeling consumption in the "log₁₀ -like" IHS scale reflects relative changes in consumption (as with a log scale) and accommodates a true zero bound (i.e., zero consumption values). The presence of a zero bound obviates the need for a separate span parameter (i.e., k) and the span of the model may be more simply defined by maximum demand at zero price (i.e., Q₀ ). Further, this reformulated model serves to decouple the exponential rate constant (i.e., α) from variations in span, thus normalizing the rate constant to the span of consumption in IHS units and permitting comparisons when spans vary. This model, called the Zero-bounded Exponential (ZBE), is evaluated using simulated and real-world data. The direct reinstatement ZBE model showed strong correspondence with empirical indicators of demand and with a normalization of α (ZBEn) across empirical data that varied in reinforcing efficacy (dose, time to onset of peak effects). Future directions in demand curve analysis are discussed with recommendations for additional replication and exploration of scales beyond the logarithm when accommodating zero consumption data.

Sex moderates the effects of experimentally induced musculoskeletal pain on alcohol demand in healthy drinkers

BACKGROUND

Pain may serve as an antecedent for alcohol use, increasing risk for hazardous drinking and associated consequences. Delayed onset muscle soreness (DOMS) induction produces clinically relevant but time-limited musculoskeletal pain. This study was conducted to determine whether DOMS induction on the dominant elbow flexors influenced alcohol demand using the Alcohol Purchase Task (APT). We hypothesized DOMS would increase alcohol demand relative to a sham control. Based on existing studies of pain self-medication, we expected DOMS-related increases in alcohol demand would be greatest in men.

METHODS

Participants (N = 53; 57 % women) were randomly assigned to a DOMS (eccentric exercise) or sham condition (concentric exercise). Participants completed the APT pre-exercise and 48 -hs post-exercise. Repeated measures GLM was used to characterize group by sex by time interactions on APT indices, including intensity, breakpoint, essential value (EV), O_max, and P_max.

RESULTS

The DOMS procedure significantly increased pain ratings at the elbow flexors. Men had significantly higher demand intensity than women across groups and time points. Significant interactive effects were detected for breakpoint and EV. From pre- to post-test, breakpoint significantly increased in men in the DOMS group. However, breakpoint and EV significantly decreased in women in the DOMS group.

CONCLUSIONS

Increased alcohol demand in men in the DOMS group was consistent with epidemiological data suggesting men are at higher risk for self-medicating pain with alcohol than women. However, decreased demand in women was unexpected. Taken together, results indicate DOMS induction may be a useful means to characterize pain as an antecedent for alcohol use.

Behavioral Economic Assessment of Alcohol and Cigarette Demand in Smokers With Alcohol Use Disorder

Background and Objectives: Behavioral economic purchase tasks are widely used to assess drug demand in substance use disorder research. Comorbid alcohol use is common among cigarette smokers and associated with greater difficulty in quitting smoking. However, demand for alcohol and cigarettes in this population has not been fully characterized. The present study addressed this gap by examining alcohol and cigarette demand among treatment-seeking smokers with alcohol use disorder (AUD). Methods: Alcohol and cigarette demand was assessed among 99 smokers with AUD. We conducted Principal Component Analysis (PCA) and correlational analyses on the demand indices. Results: Participants showed higher demand for alcohol than for cigarettes, as evidenced lower elasticity (resistance to increasing price) and higher O_max (maximum response output for drug). PCA revealed a two-factor structure (Persistence and Amplitude) for both alcohol and cigarette demand indices. Cigarette-related demand indices were positively correlated with nicotine dependence, but alcohol-related demand indices were not associated with alcohol dependence, suggesting dissociation between alcohol demand and use behaviors. Discussion and Conclusions: Our results suggest that smokers with AUD were more resistant to price elevations in relation to reducing alcohol consumption as compared to cigarette consumption, suggesting preferential demand for alcohol over cigarettes. However, it is unclear how acute substance exposure/withdrawal impacts the demand indices. Scientific Significance: Potentially differential alcohol and cigarette demands among smokers with AUD should be considered in the concurrent treatment of smoking and alcohol.

Behavioral economic measurement of cigarette demand: A descriptive review of published approaches to the cigarette purchase task

The cigarette purchase task (CPT) is a behavioral economic method for assessing demand for cigarettes. Growing interest in behavioral correlates of tobacco use in clinical and general populations as well as empirical efforts to inform policy has seen an increase in published articles employing the CPT. Accordingly, an examination of the published methods and procedures for obtaining these behavioral economic metrics is timely. The purpose of this investigation was to provide a review of published approaches to using the CPT. We searched specific Boolean operators (["behavioral economic" AND "purchase task"] OR ["demand" AND "cigarette"]) and identified 49 empirical articles published through the year 2018 that reported administering a CPT. Articles were coded for participant characteristics (e.g., sample size, population type, age), CPT task structure (e.g., price framing, number and sequence of prices; vignettes, contextual factors), and data analytic approach (e.g., method of generating indices of cigarette demand). Results of this review indicate no standard approach to administering the CPT and underscore the need for replicability of these behavioral economic measures for the purpose of guiding clinical and policy decisions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Reinforcer pathology II: Reward magnitude, reward delay, and demand for alcohol collectively relate to college students' alcohol related problems

The reinforcer pathologies model of addiction posits that two characteristic patterns of operant behavior characterize addiction. Specifically, individuals suffering from addiction have elevated levels of behavioral economic demand for their substances of abuse and have an elevated tendency to devalue delayed rewards (reflected in high delay discounting rates). Prior research has demonstrated that these behavioral economic markers are significant predictors of many of college students' alcohol-related problems. Delay discounting, however, is a complex behavioral performance likely undergirded by multiple behavioral processes. Emerging analytical approaches have isolated the role of participants' sensitivity to changes in reinforcer magnitude and changes in reinforcer delay. The current study uses these analytic approaches to compare participants' discounting of money versus alcohol, and to build regression models that leverage these new insights to predict a wider range of college students' alcohol related problems. Using these techniques, we were able to 1) demonstrate that individuals differed in their sensitivity to magnitudes of alcohol versus money, but not sensitivity to delays to those commodities and 2) that we could use our behavioral economic measures to predict a range of students' alcohol related problems.

Depression, Environmental Reward, Coping Motives and Alcohol Consumption During the COVID-19 Pandemic

Background: Increases in the incidence of psychological distress and alcohol use during the COVID-19 pandemic have been predicted. Behavioral theories of depression and alcohol self-medication theories suggest that greater social/environmental constraints and increased psychological distress during COVID-19 could result in increases in depression and drinking to cope with negative affect. The current study had two goals: (1) to examine self-reported changes in alcohol use and related outcomes after the introduction of COVID-19 social distancing requirements, and; (2) to test hypothesized mediation models to explain individual differences in self-reported changes in depression and alcohol use during the early weeks of the COVID-19 pandemic. Methods: Participants (n = 833) were U.S. residents recruited for participation in a single online survey. The cross-sectional survey included questions assessing environmental reward, depression, COVID-19-related distress, drinking motives, and alcohol use outcomes. Outcomes were assessed via retrospective self-report for two timeframes in the single survey: the 30 days prior to state-mandated social distancing ("pre-social-distancing"), and the 30 days after the start of state-mandated social distancing ("post-social-distancing"). Results: Depression severity, coping motives, and some indices of alcohol consumption (e.g., frequency of binge drinking, and frequency of solitary drinking) were significantly greater post-social-distancing relative to pre-social-distancing. Conversely, environmental reward and other drinking motives (social, enhancement, and conformity) were significantly lower post-social distancing compared to pre-social-distancing. Behavioral economic indices (alcohol demand) were variable with regard to change. Mediation analyses suggested a significant indirect effect of reduced environmental reward with drinking quantity/frequency via increased depressive symptoms and coping motives, and a significant indirect effect of COVID-related distress with alcohol quantity/frequency via coping motives for drinking. Discussion: Results provide early cross-sectional evidence regarding the relation of environmental reward, depression, and COVID-19-related psychological distress with alcohol consumption and coping motives during the early weeks of the COVID-19 pandemic. Results are largely consistent with predictions from behavioral theories of depression and alcohol self-medication frameworks. Future research is needed to study prospective associations among these outcomes.

Intravenous Alcohol Administration Selectively Decreases Rate of Change in Elasticity of Demand in Individuals With Alcohol Use Disorder

BACKGROUND

Alcohol demand is a key behavioral economic concept that provides an index of alcohol's relative reinforcing value. Initial studies have reported that alcohol demand increases during alcohol administration and in response to alcohol cues. However, the extent to which these effects are observed explicitly in samples composed of individuals with alcohol use disorder (AUD) and are operative in conjunction with each other has not been studied.

METHODS

To address this gap in the literature, we assessed alcohol demand during an alcohol challenge and subsequent alcohol cue-exposure paradigm in non-treatment-seeking, alcohol-dependent (i.e., DSM-IV criteria) participants (N = 27). Specifically, participants completed 2 counterbalanced intravenous, placebo-controlled, alcohol administration sessions followed by a controlled cue-exposure paradigm. At baseline and at breath alcohol concentration of 0.06 g/dl, participants completed the alcohol purchase task, assessing estimated alcohol consumption at escalating prices. Participants were also assessed for alcohol demand following each cue exposure.

RESULTS

During alcohol administration, there was a significant decrease in the rate of change in elasticity compared with placebo, and during the cue-reactivity paradigm, there was a significant main effect such that alcohol cues decreased the rate of change in elasticity relative to water cues. There were no statistically significant differences in other demand indices.

CONCLUSIONS

These findings provide further evidence that alcohol administration increases price insensitivity and extends the literature on alcohol's effects on demand by using a clinical sample with AUD and by adding a placebo-alcohol condition.

Evaluating alcohol demand, craving, and depressive symptoms among women in alcohol treatment

BACKGROUND

Depression and alcohol craving predict drinking and relapse rates among alcohol treatment seekers. Alcohol demand, or one's valuation of alcohol may be another determinant of drinking. There is little known about alcohol demand and its association with depression, craving, and drinking among treatment-seeking adults.

METHOD

Participants were 71 women with elevated depressive symptoms seeking outpatient treatment for alcohol use disorder (AUD). At baseline, participants self-reported daily drinking amount, alcohol craving, depressive symptoms, and alcohol demand assessed with the alcohol purchase task (APT; a task requesting participants to make hypothetical purchases of drinks at escalating prices). Baseline associations among alcohol demand, depressive symptoms, alcohol craving, and drinking severity were assessed.

RESULTS

Participants averaged 40.68 (SD = 11.78) years of age, consumed 8.84 (SD = 5.14) drinks per drinking day and reported 15.45 (SD = 7.51) heavy drinking days in the past 30 days, and had an average PHQ-9 depression score of 13.00 (SD = 4.28). Results suggest that the alcohol demand metrics of intensity (consumption level when drinks are free) and O_max (maximum expenditure on alcohol) were associated with drinks per drinking day, whereas craving and depressive symptoms were not significantly associated with drinking. The number of heavy drinking days were not significantly associated with demand, craving, or depressive symptoms.

CONCLUSIONS

These results suggest that demand may reflect unique risk for drinking relative to craving or depressive symptoms. These findings provide support for the utility of the APT within a clinical setting to assess individualized valuation of alcohol.

Behavioral economic demand as a unifying language for addiction science: Promoting collaboration and integration of animal and human models

The intersection of pharmacological, psychological, and economic theory within behavioral economics has helped advance an understanding of substance use disorder. A notable contribution of this approach is the conceptualization of reinforcement from a behavioral economic demand perspective. Demand analyses provide a multidimensional view of reinforcement in which distinct behavioral mechanisms are measured that impact decision making and drug consumption. This review describes the state of research on behavioral economic demand as a common language for addiction science researchers across varied model systems and stages of a translational continuum. We first provide an overview of the theoretical concepts and procedures used to evaluate demand in animal and human models. The potential for demand to serve as a common language for diverse research groups in psychopharmacology and addiction science (e.g., those evaluating neurobehavioral outcomes, medications development, clinical practice) is then described. An overview is also provided of existing empirical studies that, while small in number, suggest good linguistic and conceptual overlap between animal and human demand models when studying biological, environmental, and pharmacological individual difference vulnerabilities underlying drug-taking behavior. Refinement of methodological procedures and incorporation of more nuanced environmental features should help improve correspondence between animal and human demand studies as well as clinical translation of such findings. Our hope is that this review and commentary ultimately serves as inspiration for new collaborative efforts involving behavioral economic demand between animal and human researchers who share a common goal of improving substance use treatment outcomes and broader psychological wellbeing. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Translational approach to understanding momentary factors associated with alcohol consumption

Multiple interindividual and intra-individual factors underlie variability in drinking motives, challenging clinical translatability of animal research and limiting treatment success of substance use-related problems. Intra-individual variability refers to time-dependent continuous and discrete changes within the individual and in substance use research is studied as momentary variation in the internal states (craving, stressed, anxious, impulsive and tired) and response to external triggers (stressors, drug-associated environmental cues and social encounters). These momentary stimuli have a direct impact on behavioural decisions and may be triggers and predictors of substance consumption. They also present potential targets for real-time behavioural and pharmacological interventions. In this review, we provide an overview of the studies demonstrating different momentary risk factors associated with increased probability of alcohol drinking in humans and changes in alcohol seeking and consumption in animals. The review also provides an overview of pharmacological interventions related to every individual risk factor.

Contribution of alcohol- and cigarette-related cues to concurrent reinforcer choice in humans

Drug-related cues have been extensively studied for their contributions to decision-making processes involving drug consumption. Less studied is how drug-related stimuli may impact decisions involving outcomes not directly related to substance use. Studies using concurrent choice tasks have demonstrated that cocaine and cannabis cues result in robust and selective biases for monetary reinforcers contiguous with those cues. The purpose of this study was to provide a conceptual replication of these findings with alcohol and cigarettes. Participants recruited using crowdsourcing completed a cued concurrent choice task involving presentation of two cues (one drug and one neutral) followed by concurrent monetary offers below each image. Alcohol (Experiment 1; N = 103) and cigarette (Experiment 2; N = 256) visual cues were evaluated. Participants with hazardous alcohol use and current cigarette use showed greater-than-indifference selection for the alcohol- (p = .004) and cigarette-cued (p = .02) monetary choices, respectively. Qualitative responses indicated that the most popular rationale for responding was "image quality" despite images having no explicit impact on the reinforcer received. Low alcohol use (p = .03) and non-cigarette using controls (p < .001) showed an avoidance bias with lower-than-indifference selection for drug-cued choices. These findings replicate and extend observations that spatially contiguous drug-related cues can bias decisions involving concurrently presented non-drug reinforcers.

Using Demand Curves to Quantify the Reinforcing Value of Social and Solitary Drinking

BACKGROUND

Young adults typically drink in social settings and report high levels of episodic heavy drinking despite a range of adverse consequences. Behavioral economics posits that this may reflect a reinforcer pathology in which alcohol is overvalued relative to other reinforcers. Theoretically, the value of alcohol is related to both the direct pharmacological effects of alcohol (euphoria, sedation) and the associated social reinforcement, but to date no studies have differentiated the value of social vs. solitary drinking. The current study examines two modified hypothetical alcohol purchase tasks (APTs), one explicitly social and one explicitly solitary, in order to quantify the reward value of social vs. solitary drinking and to determine whether there are unique clinical correlates of solitary alcohol demand.

METHODS

Participants were young adults (N = 274, Mage  = 25.15, SD = 4.10) recruited from Mturk and from a university subject pool. Participants completed a solitary and social APT, in addition to measures of alcohol consumption and problems.

RESULTS

Participants reported significantly greater demand in the social APT compared to the solitary APT across all demand indices. Elevated solitary and social demand were associated with elevated levels of alcohol use and problems. Using a residualized change approach, solitary demand amplitude (maximum consumption and expenditure) and persistence (price sensitivity) contributed additional variance above and beyond their social APT composite counterparts in predicting typical drinks per week and the self-care, academic/occupational, and physical dependence subscales of the YAACQ.

CONCLUSIONS

The presence of peers increases alcohol demand compared to a solitary scenario, and greater relative solitary drinking demand may be a risk factor for greater alcohol consumption and problems.

Concurrent validity of the alcohol purchase task in relation to alcohol involvement: protocol for a systematic review and meta-analysis

INTRODUCTION

Alcohol demand, as measured by an alcohol purchase task (APT), provides a multidimensional assessment of the relative reinforcing efficacy of alcohol. The objective of this meta-analysis is to critically appraise the existing literature on the concurrent validity of the APT by meta-analysing the cross-sectional relationships between indices of the APT (ie, breakpoint, O_max, P_max, elasticity and intensity) and alcohol-related measures. It also aims to examine methodological procedures used to obtain APT indices and individual variables as potential moderators on the assessed estimations.

METHODS AND ANALYSIS

A comprehensive literature search conducted from inception to April 2020 will be conducted in the PubMed, PsycINFO, Web of Science and Scopus databases. Two authors will independently screen and extract data from articles using a predefined protocol search and extraction forms. Disagreements will be resolved through discussion with two additional reviewers. All results will be tabulated, and a random-effect meta-analysis will be conducted. Participants' sex, number of prices and APT methodological procedures will be examined as potential moderators on the observed effect sizes.

ETHICS AND DISSEMINATION

Results of this meta-analysis will characterise the concurrent validity of the APT in the existing literature. Further, the results are anticipated to provide evidence on which index (or indices) is most robustly associated with alcohol use and severity. Ethics approval was not required for this study and the results will be published in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42019137512.

Integrating Behavioral Economic and Social Network Influences in Understanding Alcohol Misuse in a Diverse Sample of Emerging Adults

BACKGROUND

Behavioral economic alcohol demand is a measure of motivation to consume alcohol and a robust risk factor for alcohol misuse. Social networks that are dense with alcohol are also associated with heavy drinking, but the intersection of these risk factors has not been investigated to date. This study examined these interrelationships with structural equation modeling using cross-sectional data from a diverse community sample of heavy-drinking emerging adults (N = 602).

METHODS

Latent variables for alcohol social network, alcohol demand, and alcohol misuse were constructed. Next, relations between the latent variables were examined, including the indirect effect of alcohol demand in the relation between alcohol social network and alcohol misuse. An alternative modeling testing the indirect effect of alcohol social network on the relation between alcohol demand and misuse was also tested.

RESULTS

When alone in the model, social network alcohol density significantly predicted alcohol misuse. When alcohol demand was included in the model, social network alcohol density predicted alcohol demand, alcohol demand predicted alcohol misuse, and an indirect effect on alcohol misuse through alcohol demand was present. In the alternative model, an indirect effect was not present between alcohol demand and alcohol misuse by social network alcohol density. Exploratory analyses revealed significant sex, race, and college status differences.

CONCLUSIONS

These results suggest that the influence of social network alcohol density on alcohol misuse may be, in part, through variance accounted for by alcohol reinforcing value. Longitudinal testing of this mechanistic pathway is warranted.